Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $51.79 / $68.08 / $186.06	Facility	26	$51.79	$68.08	$186.06
Aetna Facility/Professional Professional Modifier Low / Median / High Price $129.27 / $195.29 / $730.00	Professional		$129.27	$195.29	$730.00
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $46.78 / $56.90 / $183.86	Professional	26	$46.78	$56.90	$183.86
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $78.25 / $102.87 / $240.00	Professional	TC	$78.25	$102.87	$240.00
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $80.81 / $92.62 / $128.37	Professional		$80.81	$92.62	$128.37
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $38.74 / $59.75 / $84.63	Professional	26	$38.74	$59.75	$84.63
Ambetter Facility/Professional Professional Modifier TC Low / Median / High Price $61.62 / $61.62 / $61.62	Professional	TC	$61.62	$61.62	$61.62
Capital Blue Cross Facility/Professional Professional Modifier Low / Median / High Price $131.44 / $136.41 / $620.47	Professional		$131.44	$136.41	$620.47
Capital Blue Cross Facility/Professional Professional Modifier 26 Low / Median / High Price $51.36 / $83.72 / $127.20	Professional	26	$51.36	$83.72	$127.20
Capital Blue Cross Facility/Professional Professional Modifier TC Low / Median / High Price $80.09 / $134.12 / $493.25	Professional	TC	$80.09	$134.12	$493.25
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $59.04 / $59.04 / $59.04	Facility	26	$59.04	$59.04	$59.04
Cigna Facility/Professional Professional Modifier Low / Median / High Price $115.97 / $242.04 / $437.16	Professional		$115.97	$242.04	$437.16
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $37.32 / $63.18 / $102.25	Professional	26	$37.32	$63.18	$102.25
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $71.09 / $156.49 / $317.26	Professional	TC	$71.09	$156.49	$317.26
Emblem Health Facility/Professional Professional Modifier Low / Median / High Price $157.40 / $208.27 / $651.32	Professional		$157.40	$208.27	$651.32
Emblem Health Facility/Professional Professional Modifier 26 Low / Median / High Price $56.19 / $67.45 / $106.50	Professional	26	$56.19	$67.45	$106.50
Emblem Health Facility/Professional Professional Modifier TC Low / Median / High Price $95.85 / $119.36 / $170.04	Professional	TC	$95.85	$119.36	$170.04
Highmark BCBS Facility/Professional Professional Modifier Low / Median / High Price $153.83 / $168.77 / $177.68	Professional		$153.83	$168.77	$177.68
Highmark BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $57.39 / $62.90 / $84.28	Professional	26	$57.39	$62.90	$84.28
Highmark BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $124.84 / $124.84 / $124.84	Professional	TC	$124.84	$124.84	$124.84
Martin's Point Facility/Professional Facility Modifier 26 Low / Median / High Price $49.33 / $73.15 / $224.76	Facility	26	$49.33	$73.15	$224.76
Martin's Point Facility/Professional Professional Modifier Low / Median / High Price $129.27 / $187.25 / $695.00	Professional		$129.27	$187.25	$695.00
Martin's Point Facility/Professional Professional Modifier 26 Low / Median / High Price $49.32 / $65.48 / $154.69	Professional	26	$49.32	$65.48	$154.69
Martin's Point Facility/Professional Professional Modifier TC Low / Median / High Price $79.94 / $109.02 / $285.50	Professional	TC	$79.94	$109.02	$285.50
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $57.73 / $220.43 / $355.90	Professional		$57.73	$220.43	$355.90
Priority Health Facility/Professional Facility Modifier 26 Low / Median / High Price $35.84 / $59.04 / $59.04	Facility	26	$35.84	$59.04	$59.04
Priority Health Facility/Professional Professional Modifier Low / Median / High Price $124.01 / $235.00 / $405.94	Professional		$124.01	$235.00	$405.94
Priority Health Facility/Professional Professional Modifier 26 Low / Median / High Price $38.81 / $62.83 / $104.95	Professional	26	$38.81	$62.83	$104.95
Priority Health Facility/Professional Professional Modifier TC Low / Median / High Price $75.56 / $156.13 / $309.77	Professional	TC	$75.56	$156.13	$309.77
UPMC Health Plan Facility/Professional Facility Modifier 26 Low / Median / High Price $51.11 / $51.11 / $58.00	Facility	26	$51.11	$51.11	$58.00
UPMC Health Plan Facility/Professional Professional Modifier Low / Median / High Price $131.22 / $132.99 / $285.00	Professional		$131.22	$132.99	$285.00
UPMC Health Plan Facility/Professional Professional Modifier 26 Low / Median / High Price $49.78 / $51.15 / $58.00	Professional	26	$49.78	$51.15	$58.00
UPMC Health Plan Facility/Professional Professional Modifier TC Low / Median / High Price $80.09 / $81.88 / $227.00	Professional	TC	$80.09	$81.88	$227.00
United Facility/Professional Professional Modifier Low / Median / High Price $126.76 / $190.13 / $319.81	Professional		$126.76	$190.13	$319.81
United Facility/Professional Professional Modifier 26 Low / Median / High Price $47.50 / $61.12 / $100.95	Professional	26	$47.50	$61.12	$100.95
United Facility/Professional Professional Modifier TC Low / Median / High Price $77.62 / $112.11 / $241.09	Professional	TC	$77.62	$112.11	$241.09